Adoption Form

Adoption Application
Please fill out application as complete as possible. All incomplete Applications will not be evaluated. DO NOT fill out this Application if you are not seriously interested in adopting a dog. You MUST be 18 years or older to adopt a dog. Thank you for your consideration. * denotes a required field
Contact Information
Full Name *
Email *
Home Phone *
Alternate (Cell) Phone
Street Address *
City *
State *
Zip Code *
What are you major cross streets? *
About your home and what type of ACD you are looking for
What age of dog are you looking to adopt?

What color do you prefer?	Blue Red No Preference

What Gender are you looking for?	Male Female No Preference

Would you consider an Australian Cattle Dog mix or other Herding type dog?	Yes No Maybe

Is anyone in your household allergic to dogs?	Yes No

How many Adults live in the home? *

How many children live in the home? *

What are their ages?

Has everyone in the home agreed to add a dog to the family?	Yes No
If you answered No above, then please explain why?

Do you currently have pets?	Yes No
If you answered yes above, please list the (1)Name, (2) Sex, (3) Age and (4) Breed of every pet in your household.

Are your pets all current on their vaccinations?	Yes No

Are your pets altered (spayed or neutered)?	Yes No
If your pets are not altered or not up-to-date on vaccines, please explain why:

Do you have a Dog Door?	Yes No
If you don't have a dog door, would you consider installing one?	Yes No
If you answered No above, please explain why.

Do you have a Pool?	Yes No
If you have a pool, is it fenced?	Yes No

Do you Own your Home?	Yes No
If you do not own your home, can you provide us with a letter from your landlord saying dogs are allowed at the residence?	Yes No

What type of Residence do you live in?

Is the back yard fenced?	Yes No
What type of fencing, how tall and is it fully contained? *

Would you consider adopting a special needs dog?	Yes No
What types of Special Needs are you willing to consider for adoption (please check all that apply)?	Deaf Blind Incontinent Fear Aggressive Cat or Small Animal Aggressive Fearful/Submissive Dog Aggressive In Need of Obedience Training Not Housebroken Dominance Issues Medical Care Needed Prescription Meds or Vitamin Supplements I'd like to learn more

How long will your new dog be left alone during a typical day?	Minimal-I Work From Home 0 Hours 1-3 Hours 3-6 Hours 6-9 Hours 9 Hours Plus I work two Jobs

Where will your new dog be kept while you are away?

Where will your new dog sleep?

Are you familiar with Crate Training?	Yes No I'd like to learn more

Are you willing to have a New Hope Cattle Dog representative/volunteer visit your home before adoption? *	Yes No
If you answered No to having someone visit your home, please explain why not:

Are you willing to take your new dog to Obedience Classes?	Yes No
If opposed to taking your dog to Obedience Class, please explain:

Experience with Breed

Why do you want a Cattle Dog?

Have you ever owned a Cattle Dog or Cattle Dog mix?

If you have owned a Cattle Dog or Cattle Dog mix, where are they now?

If you have never owned a Cattle Dog or even if you have, please relate your experiences with the breed: *

What Research have you done on this breed (please check all that apply)?	None Read ACD FAQ by Mark Abbott Researched History of Breed Have Owned Breed Read Books specifically about breed Have trained breed Have read articles from Cattledog.com Have read New Hope site from top to bottom Have read article(s) from other websites Please send more info

Please describe what a typical day in the life of your new dog:

Veterinarian Information
Who is your current Veterinarian (please include Vet Name, Clinic Name, Address and Phone number)? *
Can we contact your Veterinarian for a Reference?	Yes No

What type of Cattle Dog are you looking for (please check all that apply)?	Working Dog Agility Competition Fly ball Competition Personal Protection Search and Rescue (Tracking) Companion for Child Companion for Adult Companion for Pet Dog to go to work with you Best Friend Outside Only (Back yard)dog

What kind of activities do you and your family participate in regularly that the new dog would be involved in (please check all that apply)?	Hiking Bike Riding Camping Running or Jogging Walking Dog Parks Play Dates w/other dogs Movies or TV watching Traveling via RV Traveling via Airplane Boating Home Schooling or Daycare Activities with Kids Dog Sports Dog Training

How would you rate your family’s overall activity level?	Never Active Active 1-2 times per week Active 3-4 times per week Active 5-6 times per week Active Daily Active only on Weekend

How do you plan on transporting your dog in your vehicle (please check all that apply)?	I don't plan to transport Open Bed of Truck Free in Backseat Crated in Vehicle Tethered/Tied/Chained in Open Bed of Truck Free in Enclosed Bed of Truck Seat belted in vehicle

Life Events

What do you plan to do with your dog in the event of a Divorce or separation with your significant other?

What would you do with your pets if you had a family member or significant other that became allergic to pets?

What would you do with your pets if you, your spouse or significant other had a Job Transfer to a different state?

What would you do if unemployment or a financial difficulty arose that forces you to move into smaller home or apartment?

What would you do if the new dog is destructive in your home or yard?

What would you do if your neighbors complained that your dog barks excessively in the backyard or house?

What would you do if your dog needed emergency surgery or care over $1000?

What would you do if your dog needed Hospice Home or Long term care (i.e. help going to the bathroom, help eating, IV Fluids, Injections, etc.)?

What would you do if your dog bites someone?

What would you do if your new dog bites you?

What would you do if your new dog fights with other pets in your home or new pets brought into your home?

Have you ever had to relinquish a pet (i.e. take to the pound, give to family/friends)?	Yes No
If you answered Yes above, please explain the circumstances:

Have you ever been involved in breeding dogs?	Yes No
If you answered Yes above, please explain:

What are the specific names of the Dog (s) from our website that you are interested in? (please list all). *

Please provide us with 3 References that can vouch for you as a dog owner. *
Reference #1
Name: *
Email address:
Phone Number: *
Reference #2
Name: *
Email address:
Phone number: *
Reference #3
Name: *
Email address:
Phone number: *

Additional Comments

Please tell us what days and times work best to schedule a home check: *

By pressing the submit button below, I am agreeing to the following statements: I have answered the questions truthfully and to the best of my ability. I understand that if I adopt a dog, I am making a commitment to providing veterinarian care, a premium dog food, life with the family indoors and out, training and socialization for whatever dog I adopt for their entire LIFETIME and if I cannot do this, I will return this dog to the care of New Hope Cattle Dogs. I am 18 years or older and I am at a place in my life where I have the time and the money to make a commitment to my adopted dog's health, socialization and training needs. I understand that the Australian Cattle Dog is a very active breed that requires continuous training, leadership and socialization, as well as plenty of exercise both mentally and physically and I will provide that for whatever dog I adopt. I understand that no Australian Cattle Dog is fool proof with cats or kids because of their intensity, prey drive, mouthiness and activity level. I have done research on the breed and/or have previously owned the breed and I feel that this breed of dog would be a good fit for me and my family. I agree to let a representative of New Hope Cattle Dogs choose the dog that would best fit my home, family and lifestyle, as they are the ones that know the dogs and the breed the best.


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Copyright 2001-2006 New Hope Cattle Dogs Rescue & Rehoming, Inc.
Created by Shannon Stevens. Maintained by Shannon Stevens and Chris.
To make Comments/suggestions/problems, please email the Webmaster.

Adoption Application

Contact Information

About your home and what type of ACD you are looking for

Experience with Breed

Veterinarian Information

Life Events

Reference #1

Reference #2

Reference #3